Include the following items:

Thank you for your interest in becoming a Polini dealer. Here is the dealer information you requested. I have included a full color scooter parts cata...
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Thank you for your interest in becoming a Polini dealer. Here is the dealer information you requested. I have included a full color scooter parts catalog along with a price list. Please help us in processing your application as quickly as possible. Be sure to fill out the dealer application completely. The application process may be delayed unless all information is furnished. Please provide all signatures requested. Include the following items: 1. 2. 3. 4.

Current local business license Sales tax permit and resale registration card California businesses must complete a California Resale Certificate Form Recent photos of your shop, both interior and exterior, including shop sign, address and customer entrance 5. Business card 6. Copy of yellow page listing or ad We are the United States distributor for Polini Motori. We currently stock the full line of motocross bikes and parts. We are beginning to focus now on the scooter parts. We are very committed to growing the scooter side of our parts distribution. In the future if we can create enough demand we would like to stock the full line of scooter and pocket bike parts in our warehouse so that they are always available to you. There is no minimum parts order or initial dealer order for scooter dealers. Turnaround time on scooter parts is generally 2-3 weeks. If there is an item that you sell frequently that you would like us to stock please let me know. I will make every to try to accommodate you if I can. Please feel free to call me if you have any questions. Keith Kanady CEO

24700 Skyland Road, Los Gatos, CA 95033 (408) 353-3537 (408) 353-8515 (FAX) WWW.POLINIUSA.COM

DEALER APPLICATION FORM Application for:

Motocross ________________

Scooter Parts ________________

Both ________________

Legal Company Name: ______________________________________________________________________________________________________________ DBA (Shop Name): __________________________________________________________________________________________________________________ Street Address: ______________________________________________________________________________________________________________________ City: ______________________________________________________ State: __________________________________ Zip: ____________________________ Billing Address: _______________________________________________________________________________________________________________________ City: ______________________________________________________ State: __________________________________ Zip: _____________________________ Business Phone: (___________)_____________ - ________________________

Business Fax: (___________)______________ - ________________________

Date Business Started: ______________________________ Contact Person: _________________________________________________________________ Email Address: ________________________________________________________________________________________________________________________ (Please provide the email address you would like to have to tracking numbers sent to.) Website URL: __________________________________________________________________________________________________________________________ (This web address will be published with a link on www.poliniusa.com) Days and Hours of Operation: __________________________________________________________________________________________________________ Name of Owner, Partner, Shareholder: _________________________________________________________________________________________________ Business type (sole proprietor, partnership, corporation): ________________________________________________________________________________ Federal Tax ID#: _________________________________________________ Date of Incorporation(if applicable): __________________________________ Franchise Dealer: Y / N

If yes, Brand(s): ____________________________________________________________________________________________

Accessories: Y / N

Repair Service: Y / N

Trackside Support: Y / N

Other: ________________________________________________________________________________________________________________________________ Trade References:

Please list three firms with whom you do business, preferably on an open basis.

Name: _______________________________________ Phone Number: (________) _________ - __________________ Open: _________ COD: _________ Name: _______________________________________ Phone Number: (________) _________ - __________________ Open: _________ COD: _________ Name: _______________________________________ Phone Number: (________) _________ - __________________ Open: _________ COD: _________

Signature of Owner, Partner, or Corporate Officer: ______________________________________________________________________________________ Name: _________________________________________________________ Title:____________________________________ Date: _______________________

24700 Skyland Road, Los Gatos, CA 95033 (408) 353-3537 (408) 353-8515 (FAX) WWW.POLINIUSA.COM

NON-AUCTION AGREEMENT Dealer agrees not to sell any Polini products on any auction sites including EBay.

ADVERTISED PRICE AGREEMENT Dealer agrees not to advertise Polini products at below retail. This includes items being advertised and sold on the internet.

ANY DEALER FOUND IN VIOLATION OF THESE AGREEMENTS WILL HAVE THEIR DEALER STATUS TERMINATED IMMEDIATELY.

Dealer Name: _________________________________________________________________

Signature:

__________________________________________ Date: _____________________

Name: _______________________________________________________________ Title: ______________________________

24700 Skyland Road, Los Gatos, CA 95033 (408) 353-3537 (408) 353-8515 (FAX) WWW.POLINIUSA.COM

HOW TO BECOME A FULL LINE DEALER!

Getting full line dealer pricing is easy! Simply agree to purchase one of each model bike at the beginning of each model year and you will receive the discounted full line dealer pricing.

It’s as simple as that. I want to be a full line dealer. Sign me up! I agree to purchase one of each model Polini dirt bike at the beginning of each model year. I may substitute the Recreation Models with additional Works models if I so choose. I understand that as a full line dealer I will receive full line dealer pricing and an ad on the Polini USA Forum. Dealers not fulfilling this agreement will have their full line dealer status revoked. Dealer: ______________________________________________________________________________________________________________________________ Signature of Owner, Partner, or Corporate Officer: ______________________________________________________________________________________ Name: _________________________________________________________ Title:____________________________________ Date: _______________________

24700 Skyland Road, Los Gatos, CA 95033 (408) 353-3537 (408) 353-8515 (FAX) WWW.POLINIUSA.COM

FAX ORDER FORM Date: ___________________________________ Dealer Name: ___________________________________________________ Contact Name: ____________________________________________________ Phone: (___________) ____________ - ________________________

Fax: (___________) ____________ - _______________________

Email Address: ________________________________________________________________________________________________________________________ Payment Type:

COD / Credit Card

If Paying by Credit Card:

Credit card on file: Y / N

Keep Credit Card Info on File: Y / N

Credit Card Number: _________________________________________________________________________ Exp date: _____________________________ Name on card: _______________________________________________________________________________ Credit Card Billing Address: ____________________________________________________________________________________________________________ City: ______________________________________________________ State: __________________________________ Zip: ______________________________ Purchase Order #: ________________________________________

Shipping: Standard / Second Day Air / Next Day Air

Shipping Address: _____________________________________________________________________________________________________________________ City: ______________________________________________________ State: __________________________________ Zip: ______________________________ Quantity

Item #

Description

24700 Skyland Road, Los Gatos, CA 95033 (408) 353-3537 (408) 353-8515 (FAX) WWW.POLINIUSA.COM

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